This proposed Research Center in Practice-Based Research is a collaboration of six well-established practice-based research networks (PBRNs) that have joined together to create the Meta-network Learning and Research Center (Meta-LARC.) Meta-LARC's mission is to sustain a consortium of practice-based research networks dedicated to increasing the quality, effectiveness and safety of primary care through accelerated research and collaborative learning. Meta-LARC networks include the Oregon Rural Practice-based Research Network (ORPRN, home of the new Center), the lowa Research Network, State Networks of Colorado Ambulatory Practices and Partners, Oregon's Safety Net West Practice-based Research Network, the Quebec Practice Based Research Network, and the Wisconsin Research and Education Network. These PBRNs are comprised of 533 primary care practices and over 6,000 clinicians who provide care for an estimated three million patients in rural, urban, and underserved communities. Combined, the networks have conducted over 200 studies and published nearly 200 scientific publications. The specific aims of Meta-LARC are described below: Aim 1: Foster the capabilities of six PBRNs and 533 primary care practices through a robust collaboration designed to conduct research to improve the quality, effectiveness and safety of primary care. Aim 2: Accelerate the conduct of PBRN research through a well designed, high functioning common infrastructure that enables the efficient conduct of research. Aim 3: Promote continuous learning and sharing across Meta-LARC networks and practices to accelerate the dissemination of knowledge and bi-directional communication. PUBLIC HEALTH RELEVANCE: Improving the quality, effectiveness and safety of healthcare is an important mission of practice-based research networks (PBRNs). Through their well-developed networks of clinical laboratories, PBRNs have the potential to rapidly translate research into clinical practice. Large collaborations of PBRNs, such as Meta-LARC, also have the ability to obtain generalizable findings often unattainable in smaller collaborations.